The Economics Behind Dialyzers

The Future of Dialyzer Technology

Although dialyzers may seem to have reached a plateau in their development, the future looks bright for future improvements. Gambro pointed out that its tradition of innovation in dialyzer technology is reflected with its release of two new dialyzer products this year, the Polyflux Revaclear and the High Cut-off membrane HC 1100. “The Revaclear dialyzer takes the hollow-fiber, single-use dialyzer to the next level. It is easier to use for the technician; it reduces ancillary costs for such items as saline and biohazard waste; and it helps protect the environment,” Rasin and Bosch said. “The High Cut-off membrane HCO 1100 has the potential to advance the treatment of multiple myeloma patients with acute renal failure. The membrane is particularly effective in dialysis treatment for the removal of nephrotoxic serum free light chains, which is a protein present at abnormally high concentrations in multiple myeloma patients and that may lead to acute renal failure.“

“Nanotechnology in biomaterials will drive the next generation of membrane engineering for more effective and efficient solute transport properties and control,” said David Marsh, Dialyzer Marketing Manager for B. Braun Medical, which manufacturers Diacap Polysulfone low- and high-flux dialzyers. “We can expect to see progressive miniaturization of current dialysis machines, monitors and devices. Membrane-based devices will be more ‘intelligent’ and probably will contain immobilized enzymes and diagnostic tools. They will probably be able to provide diagnosis, prescription and delivery of renal replacement technology.”

As has been the case for the last 25 years, the future of all development in the dialysis arena, including dialyzer technologies, is arguably driven by economics, observed Carlson. “The last significant change in dialyzer technology, synthetic high-flux membranes, was partially motivated by the expectation that equivalent therapy could be delivered in less time,” he stated. “In a dialysis facility, there is a direct association between treatment time and treatment cost. Unfortunately, this strategy is viewed by many as one of the greatest failures in the provision of renal replacement therapy in the United States and is speculated by some to be the basis of the relatively high mortality rate experienced by U.S. chronic hemodialysis patients.

“The recent trend has been for dialyzers to become less expensive. As facilities changed from multi-use to single-use dialyzers, dialyzer manufacturers have been able to capitalize on the economies of scale to reduce dialyzer costs. Additionally, there may be a shift to less expensive materials; the traditional polycarbonate dialyzer casing has been replaced with a polyolefin case in some models. This trend, however, may soon reverse because of rapidly escalating material costs; nearly 100 percent of a synthetic dialyzer is derived from oil and, as of June 2008, the price of a barrel of oil has increased 100 percent in the last 12 months. This increase in material costs may off-set any savings realized from the economics of scale, resulting in higher dialyzer prices,” Carlson concluded. RBT